The Center for the Biology of Natural Systems (CBNS), an environmental and occupational health research institute at Queens College, City University of New York, proposes to expand its current Queens World Trade Center Medical Monitoring Program (WTC MMP) to include diagnosis and treatment of WTC-related conditions. The Queens WTC MMP, which has conducted WTC responder screening since April 2003, has a monitoring population of 1,114 WTC responders, which is expected to rise to 1,400. Estimated treatment population is 450 people. The rationale for the proposed Queens WTC Medical Monitoring and Treatment Program (WTC MMTP) is threefold. The Queens WTC MMTP will have: 1) geographical convenience (Many WTC responders live in Queens, including one-quarter of all participants in the non-FDNY WTC Medical Screening program); 2) a user-friendly, community-based clinical approach: and 3) very extensive occupational medicine experience of CBNS and its consultant physicians. The borough of Queens has 2.2 million people and, standing alone, would be the fourth largest city in the U.S. The Queens WTC MMP is located in the center of Queens and, aside from a small Mount Sinai satellite, is the only WTC clinical center in New York City outside of Manhattan. The goals of the Queens WTC MMTP are 1) to provide comprehensive health monitoring and treatment services of World Trade Center-related conditions for WTC responders; 2) to assist WTC responders and their families to secure health benefits, workers' compensation and other appropriate services; 3) to characterize the evolution and new appearance of WTC-related health conditions; and 4) to communicate program results to patients, the health community, policy-makers, and the public. Among the strengths of the Queens WTC MMP are its intellectual and policy contribution to the overall non- FDNY WTC Medical Monitoring Program; its broad involvement in WTC health issues in New York City; its strong ties to the Hispanic communities of Queens, where many of the WTC immigrant responders reside; its strong leadership, team; and its participatory approach to medical screening encouraging active involvement of the WTC worker population. [unreadable] [unreadable] [unreadable] [unreadable]